I'm a breastfeeding counselor with a side hobby in educating parents and caregivers in proper car seat use. I have four sons, one born by c-section and three born by VBAC. I blog about my life with four kids, pregnancy and birth, breastfeeding, and car seats.

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Thursday, May 31, 2012

It's true, you know. Having kids, especially more than one, but even just one, changes every single aspect of your day-to-day life. Let's look at some examples.

Your car is due for service.

Before kids:
Drive car to shop. Call friend/coworker for ride to home/work, or, alternatively, catch a ride to home/work as a courtesy from the shop. When work is done, catch a ride back to shop, pick up car, and go on with life.

With kids:
Option 1) Drive car to shop. Transfer car seats to friend's car/spouse's car/mechanic's courtesy ride. Drive home. (Or, have mechanic drive you home in your car, unload kids, stroller, etc. and watch mechanic drive away in your car.) When car is done, call upon whatever method you used to get home to get back to the shop, transfer car seats (if applicable) back to your car, load up kids, stroller, etc., and drive home.

Option 2) Hire a baby-sitter or ask someone to watch your kids. Take car to shop. Call upon a friend/relative/coworker to drive you back home, or use the shop's courtesy ride. Relieve baby-sitter. When car is done, call upon baby-sitter again, find ride back to shop, get car, come home.

Either way, it's a lot more of an arrangement to make. Now, granted, if it's a short service, like just an oil change, you can hang around at the shop or walk around the neighborhood or whatever with your kids while you wait for the car to be done. Not so bad. Or, if your kids are older and in school, it's probably less complicated. I'm talking about when you have small children, still at home with you, who require car seats.

I suppose Option 3 is to prevail upon your spouse to take the car in for you. Hm.

You need to go to the post office, the bank, Costco, get gas, and pick up your dry-cleaning.

Before kids:
Figure out the most logical route to save gas. You probably want to do Costco last in case you buy any perishables. Go.

With kids:
Load kids into car seats. Make sure you have stroller or carrier for baby/toddler(s). Go to gas station and fill tank. Thank G-d for pay-at-pump. Go to Costco. Unload kids from car, put little ones in cart and/or carrier. Trudge through Costco with the bigger one's short little legs churning along behind you. "No, we can't get that." "No, we can't buy that." "No, you can't have that sample." Pay. Load up car with kids and purchases. Go home. Unload car. Nurse baby, serve lunch, use toilet, change diapers. Load up kids in car again. Go to dry-cleaners. Feel stab of guilt at leaving kids in car while you run in to pick up your stuff. Yes, it's only five minutes, but they say you should never leave young kids in the car. It'll be quick! Guilt. Put dry-cleaning in car. Go to post office. Unload kids. Wait in line holding baby in one hand and package in the other (oh good, you remembered to bring the package with you) and wishing you'd brought the baby carrier in because the line is way longer than you expected. "Don't touch that." "No, it's not free." "Don't rip that!" "Don't push that button." Send package. Load up car with kids again. Go to bank. Unload kids from car. Put baby in carrier in case there's a long line. (Oh good, you remembered the checks you needed to deposit.) Go into bank. "Sit on those chairs and don't move." "Yes, you can have a lollipop, if you behave." "Stop shrieking." "Sit down." Make deposit. Get enough lollipops to go around. Load kids into car again. Go home.

You want to see a movie. No, not a kids' movie.

Before kids:
Pick a day and time and go.

With kids:
Pick a day and time, find someone to watch them, make sure to leave food, etc. Go. Leave phone on vibrate and hope they don't call you.

Okay, that's not so much more complicated, but still. It requires a baby-sitter.

You want to go out for dinner.

Before kids:
Pick a restaurant. Go.

With kids:
Pick a family-friendly place that has food that at least half of your kids will eat. Preferably french fries. G-d forbid they should try something new, especially if you're paying for it. Get kids' menus. Retrieve crayons from floor. "What do you want to eat?" "No, they don't have hot dogs." "You can't have pizza and a cheeseburger." "Fine, have just french fries." "Yes, and ketchup." "They don't have cranberry juice. Is apple okay?" Retrieve crayons from floor. Order. "Are you eating?" Retrieve crayons from floor. "No, we're not getting dessert." "Stop screaming." Take at least one child to bathroom in the middle of eating. Retrieve crayons from floor.

I mean this mostly tongue-in-cheek of course. But it's true that having small kids definitely complicates life. Things that used to be simple, like making a few stops on the way home from work or doing something fun on the weekend, suddenly require considerably more arrangements and planning. I'm sure things get easier as your kids get older and you can either leave them home alone or they at least don't need help getting in and out of the car. It's even better when they can help you. My oldest has reached a point where he can actually be helpful in the supermarket, for example. But I think people without kids sometimes don't realize just how much more time everything takes when you have small kids along. With the loading and unloading of the car, dealing with tantrums, whining, hunger, potty, and diapers, and not wanting to tire them out too much by stacking too many errands, every outing has the potential to become an adventure.

And that is why sometimes, for parents of young children, simply going food shopping without any kids along feels like a vacation!

Thursday, May 24, 2012

It is vitally important, in child-rearing, to make a distinction between establishing a routine and enforcing a schedule. While on the surface, the two concepts seem similar and can be described in similar language, the difference in the effect each will have upon your baby's (and your) well-being is significant.

We live our lives in schedules. School schedules, work schedules, appointments, meals, everything goes by time in this world, at least for adults. It's time to wake up. It's time to eat lunch. It's time to pick up the kids from school . It's time for your doctor's appointment. It's time to take the car in for service. Time, time, time. It's natural to us to schedule things - let me look at my calendar, let's check the bus schedule - to keep our lives in sync with each other.

And yet.

And yet, it's not natural at all to babies. Babies and toddlers have no sense of time. They don't know if it's 6:30 or 7:30. They don't care if it's 10:30 or 12:00. They just don't understand the concept of an hour or a minute. It doesn't matter to them. They live their lives around their own perceptions. I'm hungry. I'm tired. I'm not tired. I'm no longer tired. I'm no longer hungry. I want to sleep. I don't want to sleep. I want Mommy to hold me. I want Daddy to hug me.

As adults, with a clear idea of the passage of time, we sometimes get frustrated with how often our babies want to eat, or how short a nap they took, or how few hours there are between night wakings. We just wish they would follow our schedules. Some baby books recommend establishing and enforcing a schedule for your baby. Feed every three hours. Put down for a nap at these times. Do not take out of crib until x amount of time has passed. Go to bed for the night at this time. Do not wake up until that time. If your baby is on a schedule, you'll be able to plan your day, and your baby will know what's expected of him.

Except, this doesn't work terribly well. Not every baby needs to eat the same amount or in the same intervals. Not every baby needs the same amount of sleep, or to sleep at the same times. Babies have their own daily rhythms, and if we try to force them into a schedule that is at odds with their internal rhythms, we can literally cause them harm. A baby who is forced into a feeding schedule may actually fail to thrive (this is a medical term: Failure to Thrive, which indicates that the baby is not growing and gaining weight as expected). In addition, a nursing mother may find her supply dwindling if she denies her baby a necessary feeding, or tries to force her baby and her breasts to follow the clock.

Instead of a schedule, whereby your baby's day is determined by the clock, what I've found to be helpful is to understand and establish routines for your baby or toddler. Small children thrive on routines in exactly the way they don't when in an enforced schedule. A routine allows a child to know what's going on now and what's happening next, so he won't be surprised. But, the difference between a routine and a schedule, to me, is that you build the routine based on the child's rhythms and needs.

Having a routine helps you, as the parent, as well. Because of your routine, you can anticipate, to a degree, when your baby will be hungry, tired, and content, and can plan your day accordingly. That's not to say that once you unlock the secret of your baby's routine, you'll have it down pat and will be able to rely upon the routine, but it helps to order your day, and the baby's day, and will help you stay sane.

There are different kinds of routines. There's your overall daily routine, which involves feedings and naps. There's how you structure a particular part of the day, like mornings and bedtimes. Your overall daily routine may dictate when bedtime is, but you can then build a bedtime routine that works well for you and your child so that he will understand that it's time to go to sleep and fall asleep more easily and peacefully.

As you add more children to the mix, the routine becomes a little more complicated, but if each child has a sense of what's going on, everyone will be happier.

And, as the rule is with babies, just when you've got him figured out, he'll change it up on you again.

For the sake of example, let me tell you about my daily routine!

We wake up in the morning, usually around 6:30 or 7:00. Typically, one or both of the older boys will wake first and come thumping down the hall and climb into bed with us. Occasionally, they sleep in a bit, and it's the baby, or even (gasp!) the alarm clock that wakes us. Usually, though, it's SB's quiet "Can you help me come up on the bed?" or NJ's heavy clambering that rouses us. NJ and SB go downstairs to watch TV (G-d bless the day they figured out how to work Netflix for themselves!) while we doze a bit, I nurse the baby or watch him sleep or let him play on the bed, and then my husband gets up and takes his shower. When he's done, I put the baby on the floor (if he's awake) to play while I take my shower and get dressed. My husband goes downstairs to make breakfast. That's basically the morning routine - for now. Once school is out, it will change, and then when school starts up again, it will change again, but for now, this has worked for us all school year.

Once my husband goes to work, I hang around with the kids until it's about two hours since the baby woke up. This is usually between 8:45 and 9:30 (he usually wakes in the morning between 6:45 and 7:30, that is to say). About that time, he gets hungry and sleepy, and I take him up to bed and he nurses easily to sleep. While he sleeps, I try to get some of my transcription work done. I never know if he'll sleep for 45 minutes or two hours, but he sleeps well for however long he sleeps. The boys play, hopefully quietly and nicely, while I work. Then around 10:00, I remember that they still are in their pajamas, and I coax them upstairs to get dressed. Sometimes the baby is awake by this time, other times he isn't. He hangs around and plays if he's up. The boys get dressed, and then it's time for lunch. (NJ is in P.M. kindergarten, so we eat lunch around 10:30 so we can walk him to school by 11:15-ish.) I make and serve lunch, we eat, then NJ gets ready for school and we all put shoes on, load up the double stroller (or the car, depending on how we're getting there that day), and it's off to school.

While NJ is at school, I may run errands, try to work, get SB together with a friend, if possible, or just hang out. GI is typically ready for his second nap about three hours after waking from his first. Depending on the length of his first nap, the time for the second nap can vary widely. Today, for example, GI took a very long morning nap, almost two hours, and thus didn't wake until around 11:00 - in fact, I had to wake him to take NJ to school. That was unfortunate. I like to let him sleep as much as he needs to. This meant he was ready for his second nap at 2:00. Sometimes, his second nap is at 12:30. Other times it's at 1:00. The length of this nap can also vary widely, from 45 minutes to (the longest ever) 2-1/2 hours. I try to plan my errands around when I think he'll be ready for his nap, so we can be home for it. I need to do most of my typing work while he sleeps, so I don't like him to nap while we're out and about, if I can help it. If not, then he sleeps when he sleeps.

Except. We have to leave to pick up NJ from school between 2:30 and 2:40. If it looks like GI's nap is going to run up against this time, I'll generally try to keep him awake until we get home from picking up NJ. This is hard and usually backfires, but I'd rather try to have him take a nap at 3:00 than wake him from a 15-minute nap at 2:30. This happened today, as mentioned. I had to keep him distracted. He did go to sleep easily at 3:00, but he only slept for 45 minutes. I don't know if that was because of his very long morning nap or because of the delay in getting him to sleep for his second nap. I have found that if I miss the sleep window, it's harder for him to fall asleep and he doesn't sleep as long or as well. After three kids, I firmly believe this is a baby-rearing truth.

Anyway, we get NJ from school, either by foot or by car, and then have a fairly fluid afternoon. Some days, I have a neighborhood girl who comes over and plays with the kids so I can work. Other days, not. Some days, we run errands after school, or have a playdate in the park, or something like that. Other days, we just hang around at home. Today was one of those hang-around-at-home days. GI took his nap, NJ and SB played, and I worked some more.

Around 5:00, if possible, I try to get ready to make dinner, and I try to serve dinner by 6:00, although that time my vary by as much as 30 to 45 minutes in either direction, depending on when I get started and how long it takes to make whatever I decide to make. Today I served almost exactly at 6:00, even though I didn't get started until after 5:30. Happened to be an easy dinner that didn't take long.

I usually let NJ and SB watch TV while I make dinner, which they did today while also entertaining GI for me. Occasionally, GI will nap during dinner or dinner prep, which is awesome. Usually, he needs to sleep about four hours after waking up from his second nap, although this is less predictable. Also, sometimes he takes a third nap, and sometimes he goes down for the night, and I often don't know which it's going to be. I'm hoping that within the next few weeks, he'll settle on a more predictable bedtime, but we'll see. It's certainly gotten easier than it was when he was a newborn and not going down for the night until 1:00 a.m.!

Anyway, that just leaves the bedtime routine! This routine has been in place, mostly unchanged in spirit, since NJ was about 10 months old. I now make them pick up their toys before bed, which sometimes goes peacefully and sometimes ends in all three (or four!) of us in tears. Today was easy, and it wasn't very messy, besides, which was also nice. We then go upstairs, where NJ chooses whether to take a shower by himself or a bath with SB. They can mostly get themselves ready for their shower/bath, except SB needs help taking off his shirt. Here's where GI's unpredictable bedtime can be irritating. Sometimes I can put him down for the night while NJ and SB bathe. When that happens, he misses out on the bedtime routine, but it makes the rest of the routine easier for me and the two older ones, because I'm not trying to baby-wrangle at the same time as everything else. GI just started crawling and pulling up (this week), so things have gotten even more interesting around here!

Anyway, they get out of their shower/bath/whatever, brush teeth, and I help SB into his pajamas (NJ does that by himself). SB picks a book for me to read, and then I read whatever chapter book NJ and I are currently working on (right now, it's Stuart Little), and I read some of that. Then we do the bedtime Shema together, and then they each pick another song for me to sing to them. Tonight it was "You Are My Sunshine" (variously referred to as "Don't Take My Sunshine Away," "There Is My Sunshine," et al.) and "Sweet Baby James," which I have been singing on and off to NJ since he was a baby. Aw. Sometimes we have a rousing chorus of "Will The Circle Be Unbroken," while other times it's a sober "Danny Boy". Then it's lights out, good night, sleep tight. If GI is still awake, I'll usually take him and hope to nurse him to sleep. Sometimes he goes down. Other times, he's just woken from what turned out to be a third nap and won't go back to sleep for at least two hours.

Then it's evening, my favorite time of day. It's quiet and peaceful, and I usually can get some more work done, write my blog, or relax in front of the TV. And take breaks to run upstairs to nurse GI back to sleep, of course.

Eventually, I get ready to go to bed, and it's off to interrupted sleep for me until the next morning, when it all starts again!

And that's what I mean by a routine. Our morning and bedtime routines are so set that the kids know exactly what to do and when and in what order. There's rarely any fighting about going to sleep or about what they need to be doing, since it's established and has been since NJ was a toddler. The rest of the day is more fluid, depending so much on what everybody has to do, but knowing the baby's rhythms for sleeping and eating makes it much easier for me to plan my day.

And you all just watch, because it's all going to change again pretty soon! It always does. But it's nice to have that bedtime routine to fall back on, invariably, almost every night, for years now. It settles the day and helps transition into nighttime peacefully.

Speaking of quiet evenings in which I work and blog, now that I've blogged, I really must return to my work and then get myself off to bed!

Tuesday, May 15, 2012

I've recently come up with a theory about parenting. That theory is that once you put a label on a parenting choice, once you name it, you've suddenly created a division or cause that never existed before, even if the practice itself is as old as time.

For example:

"Cosleeping."

I think waaaay more parents "cosleep" than are willing to admit it. The number of parents I've talked to who mention something about their child climbing into bed with them, sleeping on their chest, having to be coerced or bribed to stay in their own beds, only being able sleep cuddled up with one of them, only being able to fall asleep if Mommy or Daddy is lying in bed with them, only being able to go back to sleep if allowed to climb into Mommy and Daddy's beds, far exceeds the number of parents who simply say, "Yes, we cosleep." Cosleeping is a term that loosely refers to any arrangement whereby a baby, toddler, or small child sleeps with a parent. People who "cosleep" (and call it that) typically went into it on purpose; that is, they said, "Yes, we're going to let Jack sleep with us." On the other hand, plenty of parents "accidentally" cosleep, in that Jack will only fall asleep or stay asleep if nestled on Daddy's chest or with Mommy's arm around him.

I'll never forget baby-sitting a four-year-old girl when I was about 12, and part of my instructions in putting her to bed was to lie down next to her and put my arm around her until she fell asleep. I think it's fair to call that cosleeping, even if it's only for a brief period. And how many times had her parents fallen asleep like that, only to wake three hours later and groggily stumble back to their own bed? But I bet they never said "We cosleep."

Granted, there are plenty of parents who absolutely, positively do NOT allow their child to be in their bed EVER. But I bet it's fewer than you think.

But, suddenly, when you ask someone if they cosleep, or you tell someone that you cosleep, or coslept, or plan to cosleep, or are trying to stop cosleeping, it becomes a weird parenting "thing" that only some people do, the crunchy ones, the ones who can't let their kids go. Believe me when I tell you, I want nothing more than for my child(ren) to sleep in their own beds so I can stretch out comfortably at night. But I'm too lazy to wake up all the way to nurse somewhere else, so I'm stuck curling up with GI for a while longer. (I don't really mind that much. If I did, I'd have changed it by now.) But my husband and I also think it's good for our kids to know that if they need the security of Mommy or Daddy curled up next to them, they can have it. Certainly NJ and SB sleep the vast majority of nights on their own at this point, but it's a fairly common morning that sees all five of us in the same bed. But then, I'm one of "those" parents who actually admits to cosleeping.

What else?

"Extended breastfeeding."

I think waaaay more mothers continue to nurse past the first year than are willing to admit it. I think even mothers who desperately wanted to wean at a year or who think it's odd or wrong to nurse a toddler might find it more difficult than they expected to suddenly withhold the source of comfort and nutrition that their beloved baby has relied upon her whole life. I think plenty of mothers continue to nurse a couple times a day well past the first birthday, if only because they can't find a way to stop, or they realize that just because they've flipped another page in the calendar doesn't mean a switch has suddenly flipped in the baby's head that says "okay, I don't need to nurse anymore." I think plenty of toddlers get to cuddle up to Mommy's breast once or twice a day, even if Mommy doesn't come out and say, "Yes, I'm an extended breastfeeder." There's a lot of stigma against nursing a kid who can "ask" for it in the Western world, especially in the U.S., and I think it's entirely probable that if the "practice" of "extended breastfeeding" were more acceptable, we'd find out that plenty more women are doing it than we expect.

I know I purposely nursed SB long past his first year (I weaned him at 25 months). I know I have every intention of nursing GI just as long. So maybe I'm an "extended breastfeeder," but, really, I think I'm just a mom who sensed that her son still needed his "nur" well into his second year of life. Anyway, I had no idea how to get him to sleep without it.

I know other women who wanted to wean at a year. Some did it. Others found it not to be such a simple prospect, for whatever reason. Are they "extended breastfeeders"? I don't think they'd call themselves that. I think they'd just say, "Yes, I'm still nursing," if asked. And so what? Do we need to label every last parenting decision we make?

Perhaps the labels serve a purpose. If we have a label, we can bypass a great deal of explanation and jump right into the arguing. Maybe this isn't such a good thing. Maybe if we were required to still explain ourselves before the other person has labeled us, then that other person would be more understanding. Instead of saying "We cosleep because...", when the other person has already decided that you're a ridiculous person because you "cosleep," maybe we can say, "I let Horatio sleep with me for a few months because it was easier to nurse him back to sleep that way than to have to get up and traipse all over the house." See, with that second statement, you're not a "cosleeper," you're just another tired mom who's trying to get as much sleep as she can. Instead of "I believe in extended breastfeeding because...", where now the other person already thinks you're a crunchy weirdo for nursing a kid who can ask for it in a complete sentence, maybe we can say, "Esmerelda really needed to keep nursing after she turned one because I still couldn't get her to eat a lot of nutritious foods and she didn't like cow's milk." See, now instead of being an "extended breastfeeder," you're just a mom who's trying to make sure her child is getting all the nutrition she needs to grow, and who wouldn't want that?

Labels help us put people into categories, but there are so many directions to go when you're parenting, and so many ways to interpret any given practice, that we end up with a stack of labels that we carry with us everywhere we go. I'm a "cloth diapering, extended breastfeeding, extended rear-facing, cosleeping, natural-birth-having, WAHM." But, I don't cloth diaper because of any great environmental philosophy, which is the first thing that comes to most people's minds when you say you cloth diaper, and I don't even cloth diaper 100% of the time. I do it to save money and because it's kind of fun (except for the poop in the washer part...). I am an "extended breastfeeder" in the sense that I believe babies still need to nurse well into and possibly beyond their second year, but I also don't see myself continuing to nurse to three or four years, like some other "extended breastfeeders." I am an "extended rear-facer" because I know it's much safer for my child to rear-face as long as possible because his neck and spine cannot withstand a crash force when facing forward until he's at least two years old. I had a natural birth almost by accident because I was more afraid of having interventions than I was of the pain, and not because I had any kind of "earth mother" or spiritual need to have one. And, I work from home because we can't afford to live on one income at the moment, but we both feel it's important that I'm here and available to our children. And I happen to like my job, anyway. So now, see, all those labels? Worthless. Because I've explained myself anyway, and I don't exactly fit most people's idea of what those labels mean, and I'm certain that almost no one does.

Thursday, May 10, 2012

When NJ was a baby, he had quite a few ear infections - six, I believe, in the first 15 months of his life. It wasn't enough for the pediatrician to recommend ear tubes, but not far from it. At four months, he contracted RSV, which caused his airways to become inflamed, necessitating treatment with albuterol using a nebulizer. It also appears to have conditioned him to respond to future colds with what was called Reactive Airway Disease (RAD), basically asthma symptoms that are triggered by a cold. Almost every time he'd get a cold, he'd end up with a wheezy cough that lingered for a couple of weeks. Treatment with albuterol and sometimes oral prednisolone usually had him breathing easily again within a few days. Eventually, thankfully, he grew out of his RAD and he hasn't had a problem with it in several years now.

His ear infections and asthma were yet more fuel for my guilt over not having breastfed him. Maybe if he'd been breastfed, he wouldn't have had so many ear infections. Maybe if he'd been breastfed, he wouldn't have gotten RSV. Maybe if he'd been breastfed, he wouldn't have gotten so many colds. Maybe if he'd been breastfed, he wouldn't have had the RAD.

Indeed, SB's relative excellent health as an infant made me a believer. There's plenty of research out there to show that not breastfeeding increases a child's risk of ear infections, upper respiratory infections, asthma, diabetes, certain types of cancers, obesity, and so on, although the mechanism of protection is not always clear.

I remember reading, when NJ was a baby, that the average infant got 12 colds a year. That's one a month! NJ was certainly at the doctor almost once a month throughout his first year of life, not even counting his well baby checkups. He was rarely "well" even at those. That's not to say he was sickly, just that he often had a cold or drippy nose or cough or ear infection. It seemed like he was either just coming down with something or just getting over something or right in the middle of something, with the rare week of respite. Having a sick baby is frustrating and wearing, even if it's not a serious illness (thank G-d) or chronic condition. (I can't even imagine what it must be like if your child really is always sick. G-d bless all you parents dealing with that kind of stress.) What I began to wonder was, if formula feeding (or not breastfeeding) increases the risk of colds, ear infections, asthma, etc., then maybe it isn't "normal" for babies to be sick every month. Maybe breastfed babies aren't sick nearly so often, and that it's actually not normal (as in, natural) for infants to go around with drippy noses and achy ears almost constantly. Certainly, the fact that SB was rarely at the doctor except for well baby checkups throughout his first year bore out my expectation.

When GI was born, I placed a great deal of faith in the power of my breastmilk to protect him from his two older brothers' constant germy contact. NJ is kind enough to bring home and share every cold that comes his way at school. I will say that he appears to have quite the robust little immune system now, having been exposed to so many viruses when he was smaller. SB, however, being exposed only through NJ to all these viruses, still has not built up the wall of antibodies that appears to be working so well for NJ. At three, SB seems to come down with every cold he's exposed to, but he bears it well, mostly just getting snotty and sleepy for a few days. Both NJ and SB have the terrible habit of having fingers (and toys) in their mouths almost constantly. They like to amuse GI by blowing in his face, giving him raspberries (as in, spitting all over him), touching his hands, letting him put his hands in their mouths, touching his face, eyes, nose, and so on. Still, I had high hopes that breastfeeding would preserve him from the fate of constant colds.

Unfortunately, it seems like GI is sick more often than not, lately. After his bout of bronchiolitis not too long ago, he was healthy and happy for a few weeks. Then, suddenly, he was sick again, with the same cold both of his brothers had. NJ recovered quickly. SB is still a bit snotty but otherwise himself. But GI was up all night a couple nights back, coughing and wheezing. I took him to the doctor yesterday, where the wheeze was confirmed, and I was sent home with a nebulizer machine and a vial of albuterol, as well as oral prednisolone, and instructed to give him a nebulizer treatment up to four times a day and the prednisolone twice a day for five days to relieve the inflammation in his lungs. This was eerily familiar, as the nebulizer and the albuterol and the prednisolone were all standard features around our house when NJ was a baby, too. It's helping, though. He's breathing much more easily, coughing far less, and seems to be himself again. The only problem is that the steroids make it hard for him to sleep. But that will be over with soon enough, thank goodness.

What strikes me with all of this is that despite being 100% breastfed for the first six months and still mostly (like, 95%!) breastfed still at eight months, GI is sick almost as often as NJ was as a baby. The only difference is that GI's only had one ear infection. The doctor gave me the nebulizer machine because he sees this happening again, so we'll be prepared next time. It looks like GI is in the RAD camp alongside his big brother.

I still firmly believe that not breastfeeding increases the risk of a host of problems. I still agree that breastfeeding is normal and offers babies protection from all sorts of germs. I find myself saying, "But I did everything right! He's breastfed! We delayed cord cutting! I'm taking a Vitamin D supplement, and he gets sun almost every day. California sun!" And yet he comes down with so many colds, has this asthma problem now, and has had an ear infection. Let's face it, when the numbers aren't 100%, some people are on the "wrong" side.

So, you have your parents who say, "My kid was formula-fed, and he's healthy as a horse!" And you have your parents who say, "My kid was exclusively breastfed, and he had six ear infections and three asthma attacks by the time he was one." And both can be true, absolutely. But the issue isn't whether your kid fell into the expected category; it's whether most kids fall into the expected category.

I still remind myself that, if GI gets sick this often while breastfed, how much worse would it be if he weren't? Perhaps the asthma symptoms would have manifested sooner. Perhaps he'd have had more ear infections. Perhaps, G-d forbid, he would have been hospitalized when he had bronchiolitis instead of recovering on his own. Who knows?

Anyway, the one benefit of breastfeeding that absolutely cannot be overlooked when your baby is sick is it's ability to comfort. Being close to Mommy, feeling her skin, hearing her heartbeat, suckling, the warmth of the milk on a raw, inflamed throat, and the calm of being where he feels safest is certainly the best medicine when your baby doesn't feel well. And lying down with him as your baby drifts off into a healing sleep makes it easier for you to handle the stress of his being sick.

GI is sleeping peacefully now, where I just returned to writing after nursing him back down. When all else seems to fail, at least I know I have that to offer.

Wednesday, May 2, 2012

Incredibly, GI still has no teeth. I say incredibly, although it's not especially rare for an eight-month-old (well, eight months this coming Saturday) to still be toothless, because both NJ and SB had at least one tooth by this age. I'm enjoying the break before the inevitable teething adventure to come, but GI has been threatening to grow teeth for months now, so it surprises me that he hasn't managed to erupt one or more by now. You can see all eight front teeth just below the gum line just dying to come through, but there are no sharp edges yet!

On the subject of teeth, I took NJ and SB to the dentist yesterday. Both came through with a clean bill of health. NJ doesn't have any wiggly teeth yet, at 5-1/2. I'm not that shocked, since I didn't lose my first tooth until I was seven, but I was kind of hoping. You see, when NJ was about 27 months, he fell and ruined one of his top front teeth. It didn't fall out, but it died, and it's brown. So he's got this brown tooth in front, in an otherwise pristine set of teeth, and I'm looking forward to when he finally loses it naturally and grows in a beautiful, white permanent tooth. SB's teeth are gorgeous, white, pearly things. I think we may be lucky in that they got my good teeth. I didn't have a cavity until I was 27, nor did I have braces or any other treatment except sealants on my 12-year molars and then my wisdom teeth removed at 20. So if our kids are genetically predisposed to have teeth like mine, I'm good with that! (In the eye department, we're hoping they have their father's eyes. Nobody would want my almost-legally-blind glasses prescription.)

NJ and SB are both very good about brushing their teeth. Indeed, they seem to enjoy doing it. I certainly don't discourage them.

I was pleasantly surprised about how cooperative both kids were about getting their teeth cleaned and checked. NJ had all sorts of questions about the equipment and displays and stuff in the room. The hygienist was amused and enjoyed it.

As for growing teeth, I have absolutely no advice as far as how to ease the pain or the transition. Every kid is different. Some kids barely notice teething, while others are terribly unhappy for a few days as a tooth erupts. Typically, once the tooth cuts through and you can feel it above the gum, the symptoms ease (until the next tooth). Remember, they need to get 16 teeth in the first two years, plus four more molars around two years of age. I'm so glad I don't remember being a baby!

I can tell you that it is absolutely possible to nurse a baby with teeth. If they are latched properly, you should not feel the teeth at all. Sometimes they have to learn to adjust their latch with the appearance of a new tooth, but the "retraining" shouldn't last more than a day or two. There is absolutely no merit to the myth that you have to stop breastfeeding when they get teeth. The only issue to be concerned about is biting. A teething baby might bite to relieve discomfort, or a baby with teeth might bite just to see what will happen. The best way to respond to a bite during nursing is to pop them off immediately (use your finger to break the suction and open the jaw first!), tell them "No bite!" firmly, and wait a minute before allowing them to come back to the breast. A baby needs to learn that biting is not acceptable behavior, and that biting will result in not nursing. If you yelp or otherwise make a funny noise (which you probably will do) but there is no consequence, the baby might think it's funny and bite again just to get the funny reaction. Fortunately, SB wasn't much of a biter, so I didn't have to worry about this too much. GI has bitten down a couple of times so far, but he doesn't have teeth yet, so it hurts, but it doesn't hurt. If you know what I mean.

Breastfeeding, incidentally (or topically) aids in the proper development of jaw and teeth, as well. The muscles and suction used in nursing pull the jaw and hard palate into the proper position and shape, reducing dental and orthodontic problems later in life. So you have that as yet another argument for breastfeeding, and continuing to breastfeed even after teeth erupt. Also, breastfeeding at night is not associated with a higher incidence of infant tooth decay. When a baby sleeps with a bottle in his mouth, milk/formula/juice can pool around the teeth, encouraging tooth decay and causing "bottle caries" in young infants. Breastfeeding at night, however, does not allow the pooling of milk around the teeth. In addition, breastmilk has antibacterial properties, so the breastmilk is actually killing the bacteria that lead to tooth decay. So you don't have to worry about that, either! Go ahead and keep on nursing your teething baby!

The only issue you may have to deal with in a teething baby is that some babies find nursing painful when they're teething. The pressure generated by nursing sometimes can compound the pressure of the teeth coming in, causing pain. Most babies will want to nurse more, as the counter-pressure is usually soothing, but some babies may reject the breast during the intense period just before a tooth comes in. Don't give up. Keep offering the breast, and possibly treat the pain with ibuprofen or Tylenol, and he'll come back to it when he gets hungry, or when the tooth comes in.

As far as my teeth go, they're in pretty good shape. Pregnancy and breastfeeding can weaken the mineral deposits in the mouth, causing thinning of the enamel and cavities. In addition, your immune system is typically depressed when pregnant and nursing, which means the oral flora can be affected as well, which can cause gingivitis and other periodontal problems. I seem to be fortunate in that I haven't seen too many ill effects. One thing I have noticed, though, is that I often clench my jaw when I'm nursing the baby, which is a very bad habit, and my teeth sometimes ache from that. I try to remember to relax my jaw and not tuck my chin down into my chest when I'm nursing.